The The Incredible Incredible

HeartHeart

APL3APL3

Who Who sketched sketched

this?this?

Blood supply to the HeartBlood supply to the Heart

Supplied to the heart muscle Supplied to the heart muscle (myocardium) by the coronary (myocardium) by the coronary arteriesarteries

First 2 branches off the AortaFirst 2 branches off the Aorta Supply Myocardium with constant Supply Myocardium with constant

supply of blood.supply of blood.– Poorest: ventricular contractionPoorest: ventricular contraction– Best: ventricular relaxationBest: ventricular relaxation

Diagrams of Coronary Diagrams of Coronary vesselsvessels

Blocked Coronary Arteries Blocked Coronary Arteries (CAD)(CAD)

Angina Pectoris:Angina Pectoris: Blockage of blood Blockage of blood

flow to the heartflow to the heart Ischemia & painIschemia & pain

TX: NitroglycerineTX: Nitroglycerine Sublingual, taken Sublingual, taken

when pain occurswhen pain occurs Taken 3x every 5 Taken 3x every 5

minmin

Myocardial Infarction (heart Myocardial Infarction (heart attack)attack)

Mortality: 500K – Mortality: 500K – 700K per year in US700K per year in US

Cause:Complete Cause:Complete obstruction of obstruction of coronary artery coronary artery leading to the heartleading to the heart

Result: death of Result: death of heart tissueheart tissue

Signs & Signs & SymptomsSymptoms

Persistent chest Persistent chest painpain

Tightness in chestTightness in chest Difficulty breathingDifficulty breathing Jaw, neck, shoulder Jaw, neck, shoulder

pain (referred pain)pain (referred pain) SweatingSweating

More MIMore MI

50% of MI deaths 50% of MI deaths occur prehospitaloccur prehospital

TX: immediately TX: immediately take aspirin and take aspirin and get to hospitalget to hospital

Sex: Age 40-70 MSex: Age 40-70 M After age 70: After age 70:

male/female male/female comparablecomparable

Mortality rates are Mortality rates are declining over last declining over last several yearsseveral years

WHY??WHY??

HypertensionHypertension

““High Blood Pressure” High Blood Pressure” Systolic BP: Amount of pressure in the Systolic BP: Amount of pressure in the

aorta during ventricular contractionaorta during ventricular contraction Diastolic BP: amount of pressure in the Diastolic BP: amount of pressure in the

aorta during “rest” or atrial contraction.aorta during “rest” or atrial contraction. Normal was 120/80 mm/Hg. Now Normal was 120/80 mm/Hg. Now

changed to 115/75 mm/Hg. changed to 115/75 mm/Hg. Puts added stress on heart and vesselsPuts added stress on heart and vessels

ThrombusThrombus

Ex: Coronary Ex: Coronary Thrombosis (blood Thrombosis (blood clot)clot)

Build-up of Build-up of plaque(atherosclerplaque(atherosclerosis can narrow osis can narrow arteries for blood arteries for blood flow and clot forms flow and clot forms oror

Rupture of plaqueRupture of plaque

EmbolusEmbolus

Ex: Pulmonary Ex: Pulmonary EmbolismEmbolism

Obstruction Obstruction caused from caused from “floating” clot or “floating” clot or bubble of gasbubble of gas

““Floating” clot Floating” clot gets stuck and gets stuck and blocks all blood blocks all blood flow.flow.

Congestive Heart Failure Congestive Heart Failure (CHF)(CHF)

Fx as a pump is Fx as a pump is impaired due to:impaired due to:

A. Diseases that A. Diseases that weaken heartweaken heart

B. diseases B. diseases causing stiffening causing stiffening of heartof heart

C. diseases that C. diseases that increase oxygen increase oxygen demanddemand

Cerebral Vascular Accident Cerebral Vascular Accident (CVA/Stroke)(CVA/Stroke)

Lack of blood supply to the brain that Lack of blood supply to the brain that can result in a decrease in can result in a decrease in neurological/physical fx, caused by neurological/physical fx, caused by bleeding into the brain, or formation bleeding into the brain, or formation of a bloodclot that blocks an artery to of a bloodclot that blocks an artery to the brain the brain

AneurysmAneurysm

An An aneurysmaneurysm (or (or aneurismaneurism) is a localized, ) is a localized, blood-filled dilation (balloon-like bulge) of a blood-filled dilation (balloon-like bulge) of a blood vessel caused by disease or weakening blood vessel caused by disease or weakening of the vessel wall. Aneurysms most of the vessel wall. Aneurysms most commonly occur in commonly occur in arteriesarteries at the base of the at the base of the brain (the brain (the circle of Williscircle of Willis) and in the ) and in the aortaaorta (the main artery coming out of the (the main artery coming out of the heartheart), a ), a so-called so-called aortic aneurysmaortic aneurysm. The bulge in a . The bulge in a blood vessel can burst and lead to death at blood vessel can burst and lead to death at any time. The larger an aneurysm becomes, any time. The larger an aneurysm becomes, the more likely it is to burst.the more likely it is to burst.

Quick Quiz- 10 pointsQuick Quiz- 10 points

1. Why can the same coronary artery 1. Why can the same coronary artery be of a different level of importance be of a different level of importance from one person to another?from one person to another?

2. List 2. List 2 important interventions2 important interventions for for someone who is suspected of having someone who is suspected of having a a myocardial infarctionmyocardial infarction

3. Explain the connection between a 3. Explain the connection between a thrombusthrombus and and atherosclerosisatherosclerosis

Questions cont.Questions cont.

4. Describe 4. Describe what CHF iswhat CHF is and what and what treatmentstreatments are usually done for it are usually done for it

5. List 5. List 3 things3 things that you would have that you would have a person suspected of having a a person suspected of having a CVA CVA dodo. . WhyWhy would you do this? would you do this?